Saturday, December 1, 2012

How Are You Sleeping These Days?

The first clue I had that something was the matter was waking up each morning with a headache. My other major symptom was awakening many times a night and periods when Bob would start awake, suddenly aware that I wasn't breathing. And some days, I would be so tired that I caught myself falling asleep in meetings at work (not good) or at stop signs or red lights when driving (even worse.)

For Bob, who is slender, fit and amazingly healthy for his age, his major symptom was incredible snoring, snoring that could lead to a lot of nocturnal pokes and jabs from me or send one of us out to the living room couch some nights and inspire me to buy great quantities of ear plugs.

For far too long, we simply lived with these symptoms, attributing them to yet another aspect of aging. I tried evening meditation and soothing sound machines in quest of a restful sleep. Bob tied a tennis ball to the back of his nightshirt to keep from rolling onto his back during sleep -- his prime snoring position. Countless others do the same -- simply accept sleep disturbances as part of aging or look for products to help the night time symptoms or daytime drowsiness.

Such symptoms, indeed, have spawned whole new product lines -- from "snore" rooms in new homes for the over-55 crowd to super-caffeinated beverages to over-the-ear devices that alert you when your head drops in sudden sleep when you're driving. And historically, there also has been a lot of joking about snoring and snorting during sleep.

But the cause of these symptoms is no laughing matter and something that neither snore rooms nor Jolt nor alert devices can fix: obstructive sleep apnea.

This sleep disorder is estimated to affect between 18 and 28 million Americans, the vast majority of whom don't realize they have it.  With obstructive sleep apnea, soft tissue at the back of the throat sags during sleep and closes off the airway. The brain quickly alerts the sleeper, who wakes briefly, often many times an hour, gasping for air or who simply snores loudly through the night. As a result of these unremembered awakenings and oxygen deprivation, sometimes dipping below 65% of optimal blood oxygen levels, those with sleep apnea may wake up with headaches or feeling unrested or may experience daytime drowsiness.

While people of all ages and sizes can suffer from sleep apnea, those at particular risk are older, obese and more often male. However, older women, especially those who have been diagnosed with high blood pressure and whose Body Mass Index exceeds 30, may be at special risk as well.

Sleep apnea, and the disrupted sleep this condition causes, is a risk factor itself in a number of disorders including hypertension, a heightened risk for heart attack, stroke, Alzheimer's disease, type 2 diabetes, congestive heart failure and depression. Some people die in their sleep from apnea or apnea-related causes like heart attacks and strokes.

So how can you find out if you have sleep apnea and what can you do about it?

If you have any of the symptoms described above -- like snoring, awakening with a snort or gasp multiple times a night, morning headaches, daytime drowsiness -- talk with your doctor. He or she may refer you for a sleep study.

Sleep studies - which monitor brain and heart activity, breathing, arm and leg movement and oxygen levels throughout the night as you sleep -- are most often done at sleep disorder centers. Bob spent a night at a hospital-based center while I spent my restless night at an independent sleep center that was in  a medical office building. In both cases, we had our own rooms with comfortable beds. The major  difference: monitoring wires and cameras and occasional visits from technicians. These on-site studies can be expensive -- between $1,500-3,500 -- but in our cases, Medicare paid the entire amount.

If cost is a factor or if you can't imagine trying to sleep wired up away from home, there is a portable sleep study device called SleepQuest that a sleep specialist can provide for you at less cost ($400-650) that is also often covered by insurance.

Bob and I both were diagnosed with sleep apnea -- mine moderate, his severe. And we were both prescribed continuous positive airway pressure (CPAP) machines last March. Once again, Medicare covered the cost completely. Each machine was set to a prescribed air pressure to blow just the right amount of air necessary to keep our airways open and were fitted by a respiratory therapist who came to our home to make sure we understood how to use the devices.

Although the CPAP machines -- which can be fitted with a whole face or partial face mask or with "nose pillows" that fit directly into the nostrils -- can feel strange at first, persisting through any early discomfort is well worth the effort. We noticed an immediate improvement in sleep quality and feeling rested each morning. A cautionary note to others who may be getting CPAP machines through Medicare: there is a monitoring microchip in the device for the first 30 days to measure your compliance. You need to use the device most of the night, most nights, during that time in order to keep the device. Actually, this is a good motivation to stick with it: if you use it as directed for that first month, you won't want to be without it!

While CPAP machines are the most common ways of treating obstructive sleep apnea, some people find relief for their symptoms by using a specially fitted oral device made by a dentist to move your lower jaw forward, thus opening the throat. This is also quite often covered --in full or in part -- by insurance.

For those with milder sleep apnea who are not mouth breathers and who don't suffer from nasal allergies, there is a new device called Provent -- a small, disposable patch that fits over each nostril and uses your own breathing to create positive airway pressure to keep the throat open. These are available only by prescription and are not yet covered by insurance or Medicare.

I ran into a neighbor today -- thin, fit and in her 50's -- who told me that she had just been diagnosed with sleep apnea. She spent her first night last night on the CPAP and, to her great relief, did not have a panic attack and did wake up feeling more rested.

I'm still thankful that my husband sounded the alarm for me --and I for him. I'm grateful that our doctor referred us to sleep specialists. In my case, I complained about poor sleep quality and asked if sleeping pills might be the answer. He looked at me with great concern. "I want to test you for sleep apnea before prescribing anything," he said. "Because if you have sleep apnea and take a sleeping pill, there is a chance that you'll never wake up."

Thousands of people with undiagnosed sleep apnea die in their sleep every year -- from sleeping pills, from heart attacks or strokes.

So if, like ours, your sleep is far from peaceful these days, don't pop a pill or just chalk it up to another aspect of aging.

Check with your doctor now. It could save your life.


                       Romantic it isn't, but the CPAP can be a life-saver!


19 comments:

  1. First of all, the picture of you two in your masks is terrific!

    Second, this is a timely warning. My dad was finally fitted with one after years of not sleeping well, feeling unrested, etc. His dr. said his heart couldn't have taken the sleep apnea too many more years.

    So thank you for putting this out there and sharing your experiences. I'm sure it will will help many others!

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  2. Hmm...hubby snores like crazy and I wake up exhausted. Me thinks we should explore this possibility. Thanks for the information. Another wise tip from Dr. Kathy!

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  3. Hi DrMcCoy,
    My husband is slim and fit too but snores loudly and stops breathing and gasp for air while he sleeps and also has to have at least three naps in the daytime.

    We have been married for almost 47 years and he has always been like this.
    I sent him to see his doctor who sent him to see another doctor. This second doctor asked my husband if the snoring was bothering him and he said no but my wife is complaining. This doctor just sent him home and I was not happy. We both have to sleep in separate beds because of his loud snoring.
    I will read your post to him.
    Thanks.
    JB

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  4. While in the hospital in intensive care some years ago they suspected I had sleep apnea. Fortunately weight loss took care of my problem. Now that I've gained a few pounds again, once again I'm snoring. I'm back on working to lose weight. I really don't want to have a CPAP machine. Three of the group of bloggers that got together at Vashon Island last October had machines. I think it's one of those things that those of us of a certain age should suspect when we have any of those symptons you mention. Nice informative post.

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  5. lol I'd hate to sleep like this lol

    My brotherinlaw has sleep apnea and he did have some sort of stroke and he is also deaf now. No one knows why.

    Sometimes I snore but then I find if I sleep elevated, it is fine and I sleep well and deep. When you are over tired you sleep wrong and snore. We often fall asleep with our TV on and this work on the brain even when you're conked out.
    People are surrounded by electricity all day long and this is not good for your health. TV radio lights computers telephone, iphones cell phones
    The best way to sleep is to open the windows and let the cold fresh air inside while under warm cozy blankets.
    You wake up refreshed and happy.
    I always slept like this till I got married . My husband needs 50 pillows over his head and all the windows and curtains shut with the TV blasting. Otherwise he can't sleep. lol
    This has been a losing battle for me, between the two of us for 40 years.lol
    When I was young I was a light sleeper. I always wished we didnt have to sleep because lifes' so short. Now I don't sleep much either but when I do, it's very deep. You can kill me and I wont feel it.That's called getting old. lol

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  6. I think it is wonderful you have both found the answer and relief. Lots of great information here, especially about the insurance coverage. Some people probably hesitate testing for fear of the cost.
    So far I think I am OK but will use those masks as incentive to get rid of the rest of my poundage as a preventive. They look like they would take some getting used to.

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  7. Thank you for the detailed information on this condition and treatment, Kathy. It's something we hear about often, but not in detail, especially the risks of not getting treated.

    I'm glad you got used to your machines without too much discomfort!

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  8. That photo is priceless! If my husband and I had those devices on, I would laugh so much. I've already gotten a little laugh from seeing you in it.

    Fortunately, I'm still sleeping well. My husband is not a good sleeper and I feel so sorry for him. I think he can't settle down and worries. He doesn't snore, so it's probably not sleep apnea.

    Thank you for posting your story and this information. Best wishes to both of you.

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  9. If The Man and I had to wear those devices at bedtime I'm afraid we'd both die of Hysterical Uncontrollable Laughter!

    Dying in one's sleep I don't see as all bad though... if I gotta go out its more Peaceful than many alternative forms of Death. But this is good info to know, thanks for Sharing.

    Dawn... The Bohemian

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  10. You guys look like us! My husband has had his machine for two years and I've had mine for about four months. My apnea was moderate; the only symptom I had was the need to take an afternoon nap. Now that I have my machine that rarely happens.

    The only side effect I don't like is the mark the mask strap makes on the side of my face when I sleep wrong. The rest of it is just fine, thanks!


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  11. Love the picture of you and your husband! My husband snores so bad at times that he sounds like a chainsaw cutting down trees. I've noticed a pattern with his snoring. He snores more when he is really tired from working too much. Sleeping on his side doesn't help when he's really tired. He will not go to the doctor for anything.

    I on the other hand have had a doctor or two that have wanted to send me for a sleep study. I declined. My husband says he don't think I quit breathing during the night. I think most of my sleep problem is because of waking up from hearing him snore! lol I'm also taking Tamoxifen. I think it is messing with my sleep that I'm not sleepy at all right now and it is almost midnight. Now, in the morning around 8 or 9 when I get up I am so tired I want to sleep longer. I do sleep longer if I don't have anything planned for the day! lol In short, I'm tired all day but when I should be in bed I'm wide awake.

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  12. Scary! And scary looking devices.

    My problem is that I can’t go to sleep, therefore I often need to resort to a sleeping pill. Sometimes I sleep well for a week and then, suddenly, I’m awake for two or three nights. It’s a bother.

    I’ve worked out how to get past Google+, I needed to go to ‘About’ before your blog popped up.

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  13. Dear Kathy, thanks for this very informative posting on sleep apnea. My brother has it and uses a device. Probably the one you and your husband are wearing. (I haven't asked to see it.)

    I just noticed this evening your new photograph by the "about me" section. It's a lovely photo because your smile is so welcoming. And you seem delighted. Peace.

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  14. I love the picture! Wonderful.

    My husband had sleep apnea and snoring about 30 years ago - when he was smoking. He gave up smoking and it went away. Now I don't think either of us snore or stop breathing. But I did start melatonin just recently before poor sleep and it did wonders for me. It isn't a drug that puts you to sleep but a hormone that allows you to sleep. This hormone is naturally made by the body and as we age, sometimes we don't make enough melatonin on our own. Apparently that is the case for me. Certainly one should check with their doctor before starting anything for sleep - just like you did and I did. Melatonin is an option for those where apnea and snoring are not the issue.

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  15. Finally finding some time to read blogs. I love the photo of you and your hubby. So great of you to promote this solution for sleep problems. I'm sure it will help many people. Luckily I'm sleeping well lately. I just don't need a wedding on my mind, that helps wonders. LOL :)

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  16. A serious post with a humorous ending. :-) I like it.

    Pearl

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  17. Hi Kathy,
    I missed seeing this post until today. I have not had much time for blogging lately. This was a very informative post. I hope those who think they might have sleep apnea, or even those who are in denial about their sleeping problems, will head the lessons you teach here.

    You and I have matching masks. It must be what all the hip women of our generation are wear. LOL It is a Pilairo Nasal Pillow right? That is what I wear. My husband wears a full mask that covers his mouth. He really likes his. I like mine. It all works. I wrote a post once called "Masked Lover." That is what I call my hubby, my masked lover.

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  18. Love, love, love that photo! It's wonderful -- those smiles! I have a number of friends who deal with sleep apnea. I've been fortunate so far -- but you never know. This post helps so many. Sweet dreams!

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